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| Value of Circulating Tumor Cells and Tumor Markers in Peripheral Blood for Evaluating the Curative Effect on Elderly Patients with Non-Small Cell Lung Cancer After Chemotherapy |
| LI Xiaohua, LI Jie, TANG Junwei |
| Nanchong Central Hospital, North Sichuan Medical College, Sichuan Nanchong 637000, China |
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Abstract Objective: To explore the value of circulating tumor cells (CTCs) and tumor markers in peripheral blood for evaluating the curative effect on elderly patients with non-small cell lung cancer (NSCLC) after chemotherapy. Methods: A total of 86 elderly NSCLC patients admitted to the hospital from September 2017 to February 2019 and confirmed by pathological examination were enrolled as the research subjects. All underwent chemotherapy with docetaxel and cisplatin. The levels of CTCs in peripheral blood, serum neuron specific enolase (NSE), cytoplasmic thymidine kinase-1 (TK-1) and midkine (MK) were detected before chemotherapy. The clinical curative effect after 6 months of treatment was evaluated. The evaluation value of peripheral blood CTCs, serum NSE, TK-1 and MK for curative effect on elderly NSCLC patients after chemotherapy was analyzed by univariate analysis, multivariate Logistic regression analysis and ROC curve analysis. Results: After chemotherapy, there were 49 cases (56.98%) effective, who were included into effective group, and there were 37 cases (43.02%) ineffective, who were included into ineffective group. After test, levels of serum NSE, TK-1 and MK, and positive rate of CTCs in ineffective group were significantly higher than those in effective group (P<0.05). The positive rate of CTCs was significantly positively correlated with the expression of serum NSE, TK-1 and MK (P<0.05). The results of univariate analysis showed that there were significant differences in TNM staging of tumors, peripheral blood CTCs, serum NSE, TK-1 and MK between the two groups (P<0.05). The results of multivariate regression analysis showed that positive peripheral blood CTCs, serum NSE not lower than 40.0 ng/ml, TK-1 not lower than 4.5 ng/ml and MK not lower than 0.8 ng/ml were independent predictors of ineffective curative effect on elderly NSCLC patients after chemotherapy. The results of ROC curve analysis showed that area under the ROC curve (AUC) of serum NSE, TK-1 and MK alone for predicting ineffective curative effect on elderly NSCLC patients after chemotherapy was lower than that of their combination (P<0.05). Conclusion: The high positive expression rate of peripheral blood CTCs, and high expression of serum NSE, TK-1 and MK are important influencing factors of ineffective curative effect on elderly NSCLC patients after chemotherapy. The combined detection of the three is of good application value in evaluating the curative effect on elderly NSCLC patients after chemotherapy.
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2021, Vol. 27 
